title: Parental depressive symptoms and childhood cancer: the importance of financial difficulties.
abstract: OBJECTIVE
  Research suggests a relationship between caring for a child with cancer and psychological distress in caregivers. Less evident is the role which financial difficulties might play in this relationship. We sought to determine if caring for a child with cancer was related to clinically relevant depressive symptoms among parents, whether or not financial difficulties mediated this relationship, and if financial difficulties were independently associated with symptoms of depression among parents of children with cancer.
  
  
  METHODS
  Data are from 215 parents of children diagnosed with cancer or brain tumors (n = 75) and a comparison group of parents of healthy children (n = 140). Multiple logistic regression analyses were used to assess the factors associated with reporting clinically relevant depressive symptoms.
  
  
  RESULTS
  Caring for a child with cancer was associated with increased odds of clinically relevant depressive symptoms in parents (OR = 4.93; 95 % CI 1.97-12.30), controlling for covariates. The mediating effect of financial burden on this relationship was not statistically significant. However, among parents of children with cancer, negative financial life events increased the likelihood of reporting symptoms of depression (OR = 4.89; 95 % CI 1.26-18.96).
  
  
  CONCLUSIONS
  Caring for a child with cancer was associated with depressive symptoms for parents. Financial difficulties were the strongest correlate of these symptoms among parents of children with cancer. Our results suggest that it may not only be the burden of caring for the child with cancer but also the associated financial difficulties that contribute to a higher likelihood of depressive symptoms in parents.
authors.affiliation: Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 North Walnut Street, WARF Office 503, Madison, WI, 53726, USA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Creswell
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Wisk
authors.forename: Kristin
authors.initials: K
authors.lastname: Litzelman
authors.forename: Adelyn
authors.initials: A
authors.lastname: Allchin
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000191:economics / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000191:economics / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000191:economics* / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D012923:Social Class